VA Conjoint Survey - External Communication

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCA, VBA, VHA)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0770 can be found here:

Documents and Forms

Document Name Document Type
Form 10-1500188(WS) VA Conjoint Survey - External Communication Form and Instruction
10-1500188(WS) VA External Communication Conjoint Questionnaire VA External Communication Conjoint Questionnaire 11-12-2015.docx Form and Instruction
VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx VA Generic Fast Track Clearance Request IC Document
VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx VA Generic Fast Track Clearance Request IC Document

Information Collection (IC) Details

IC Title:	VA Conjoint Survey - External Communication	Agency IC Tracking Number:	2900-0770

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-1500188(WS)	VA External Communication Conjoint Questionnaire	VA External Communication Conjoint Questionnaire 11-12-2015.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 800	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
VA Generic Fast Track Clearance Request	VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx	11/03/2015
VA Generic Fast Track Clearance Request	VA Generic Fast-Track Clearance Request_VHA OSI Conjoint Analysis_External Communications Conjoint_10 302015.docx	11/03/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.